title: Vaginal hysterectomy versus total laparoscopic hysterectomy for benign disease: a metaanalysis of randomized controlled trials.
abstract: OBJECTIVE
  Recent randomized trials comparing total laparoscopic hysterectomy (TLH) and vaginal hysterectomy (VH) have produced conflicting results. The role of TLH in women suitable for VH remains uncertain.
  
  
  METHODS
  This study was a metaanalysis of randomized studies comparing TLH and VH for benign disease. Pooled outcome measures (odds ratio [OR] and weighted mean difference [WMD]) were calculated using random-effects models.
  
  
  RESULTS
  No differences in perioperative complications, either total (pooled odds ratio, 0.87; P = .74) or by grade of severity, were demonstrated. TLH was associated with reduced postoperative pain scores (WMD -2.1; P = .03) and reduced hospital stay (WMD -0.62 days; P < .0001) but took longer to perform (WMD 29.3 minutes; P = .003). No differences in blood loss, rate of conversion to laparotomy, or urinary tract injury were identified.
  
  
  CONCLUSIONS
  TLH may offer benefits compared with VH for benign disease, although this analysis is likely underpowered for rare complications. Further studies of long-term outcomes, including prolapse, urinary incontinence, and sexual function, are required.
authors.affiliation: Faculty of Medicine, University of New South Wales, Sydney, Australia.
authors.forename: Rasha
authors.initials: R
authors.lastname: Gendy
authors.forename: Colin A
authors.initials: CA
authors.lastname: Walsh
authors.forename: Stewart R
authors.initials: SR
authors.lastname: Walsh
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Karantanis
mesh_terms: D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D007045:Hysterectomy, Vaginal / Q000379:methods; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D010149:Postoperative Pain / Q000209:etiology; D016032:Randomized Controlled Trials as Topic